[Congressional Record Volume 144, Number 148 (Friday, October 16, 1998)]
[Senate]
[Page S12660]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             MEDICARE HOME HEALTH FAIR PAYMENT ACT OF 1998

  Mr. JEFFORDS. Mr. President, I am pleased to report to my colleagues 
that yesterday afternoon a tentative agreement on home health care was 
reached by negotiators from the House and the Senate. This agreement 
will throw a much needed lifeline to our Nation's senior citizens who 
rely on home health care to provide much needed health services within 
the surroundings of their homes.
  Home health care is the cornerstone of the health care safety net for 
senior citizens. It spares them the dislocation of moving to a hospital 
or nursing home, and it spares the taxpayers from paying for such 
costly services when they are not really needed.
  The administration has implemented reductions in home health care 
services that treat every agency exactly the same, regardless of 
whether the agency is efficient or wasteful. The result is that the 
most efficient agencies are being hit with cuts they cannot absorb. 
Vulnerable senior citizens in my State are on the brink--on the brink--
of losing their vital services.
  Under the proposal, payments to the older, low-cost home health 
agencies will be increased and an additional 15 percent across-the-
board cut scheduled for next fall will be delayed for 6 months. That is 
the time when they say the proposed payments which will get us out of 
this mess will be available. Adoption of this bill will give home 
health agencies needed financial relief until a new prospective payment 
system is in place.
  All we need now is for the administration to also agree to help our 
senior citizens who rely on home health care, as was wrapped into the 
omnibus bill yesterday. I call upon the President in the strongest way 
I possibly can to join us in saving hundreds and thousands of home 
health care services from being forced to cut back on critical 
services.
  Today is a day of political spinning. The media will examine who won 
and who lost, what provisions are in and what provisions are out. We 
must take that time to make things right for senior citizens who need 
our help.
  Over the last 8 months, I have been working as hard as I know how to 
find a solution for the crisis faced by our home health care agencies 
in Vermont. Our 13 home health agencies are model agencies that provide 
high-quality, comprehensive home health care with a low price tag. 
However, under Medicare's new interim payment system, the payments to 
the agency are so low that Vermont seniors may be denied access to 
needed home health services. They are the lowest cost in the whole 
United States.
  For the past 7 years, the average Medicare expenditures for home 
health care in Vermont have been the lowest in the Nation. However, 
rather than being rewarded for this cost-effective system, Vermont has 
been penalized by the implementation of the current interim payment 
system. In June 1998, Vermont's home health agencies projected the 
statewide impact of their current interim payment system was a loss of 
over $4.5 million in Medicare revenues for the first year. These are 
nonprofit agencies in our little State. This represents a loss of over 
11 percent on an annual base of $40 million statewide.
  Vermont is a good example of how the health care system can work to 
provide for high-quality care for Medicare beneficiaries. Home health 
agencies are a critical link in the kind of health system that extends 
care over a continuum of options and settings. New technology and 
advances in medical practice permit hospitals to discharge patients 
earlier. They give persons suffering with acute or chronic illness the 
opportunity to receive care and live their lives in familiar 
surroundings. Time and time again, Vermont's home health agencies have 
proven their value by providing quality, cost-effective services to 
these patients. Yet, time and time again, Federal policy seems to 
ensure that their good deeds will go punished.
  The home health legislation is the product of a great deal of hard 
work by the majority leader, Senators Roth and Gramm, and Congressmen 
Thomas and Bilirakis. I worked with them yesterday before we reached 
our conclusion. The signing of this bill will mark a victory for our 
State and also reflect a strong nationwide commitment to high-quality, 
cost-effective home health agencies such as those in Vermont.
  I anguish as I wait today to know what will happen at the White 
House. I ask the President, call upon him, to make sure that they do 
not destroy this wonderful work that was accomplished yesterday to save 
our home health care system.

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